Impact of COVID-19 pandemic on psychophysical stress in patients with adrenal insufficiency: the CORTI-COVID study
Impact of COVID-19 pandemic on psychophysical stress in patients with adrenal insufficiency: the CORTI-COVID study
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DOI：
10.1007/s40618-020-01422-2
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发表时间：
2020-09-18
影响因子：
5.4
通讯作者：
Arnaldi, G.
中科院分区：
文献类型：
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作者：
Martino, M.;Aboud, N.;Arnaldi, G.
目的COVID-19是肾上腺功能不全（AI）患者面临的一种新的威胁，其预期寿命和质量（QoL）因感染风险增加和压力触发的肾上腺危象（AC）而受损。如果感染，AI患者需要立即更换剪裁。我们在AI患者队列中评估了：COVID-19的患病率和临床表现; AC的患病率以及与并发COVID-19或流行病相关的心理物理压力的相关性;封锁引起的情绪负担和健康相关的生活质量。方法在单中心（安科纳大学医院，意大利），涵盖2020年2月至4月的横断面研究，121（40例原发性，81例继发性）AI患者（59名男性，55 +/- 17岁）完成了三份远程调查问卷：专门构建的“CORTI-COVID”，评估病史和对COVID-19相关全球健康，AI特定个人健康，职业，经济和社会后果; AddiQoL-30; SF-36健康调查。结果COVID-19发生在一名48岁的原发性AI女性（0中心点8%患病率）中，她及时为她量身定制了替代品。呼吸困难持续3天，无需住院。未涉及继发性AI患者。未发生AC，但流行病相关应激导致6/14例糖皮质激素上调。各组之间CORTI-COVID均值相似，主要取决于原发性AI中的“个人健康”（rho = 0.888，p < 0.0001）和继发性AI中的“经济”（rho = 0.854，p < 0.0001）。工作限制增加了职业问题。CORTI-COVID与QoL呈负相关。AddiQoL-30和SF-36密切相关。合并症使患者的QoL恶化。结论如果在预防急性事件方面做出教育努力，AI患者似乎并不特别容易感染COVID-19。新的“CORTI-COVID”问卷可靠地评估了AI中与流行病相关的情绪负担。即使在非常规的压力下，受过教育的AI患者也能保持良好的生活质量。
Purpose COVID-19 is a novel threat to patients with adrenal insufficiency (AI), whose life expectancy and quality (QoL) are impaired by an increased risk of infections and stress-triggered adrenal crises (AC). If infected, AI patients require prompt replacement tailoring. We assessed, in a cohort of AI patients: prevalence and clinical presentation of COVID-19; prevalence of AC and association with intercurrent COVID-19 or pandemic-related psychophysical stress; lockdown-induced emotional burden, and health-related QoL. Methods In this monocentric (Ancona University Hospital, Italy), cross-sectional study covering February-April 2020, 121 (40 primary, 81 secondary) AI patients (59 males, 55 +/- 17 years) completed telematically three questionnaires: the purpose-built "CORTI-COVID", assessing medical history and concern for COVID-19-related global health, AI-specific personal health, occupational, economic, and social consequences; the AddiQoL-30; the Short-Form-36 (SF-36) Health Survey. Results COVID-19 occurred in one (0 center dot 8% prevalence) 48-year-old woman with primary AI, who promptly tailored her replacement. Dyspnea lasted three days, without requiring hospitalization. Secondary AI patients were not involved. No AC were experienced, but pandemic-related stress accounted for 6/14 glucocorticoid up-titrations. Mean CORTI-COVID was similar between groups, mainly depending on "personal health" in primary AI (rho = 0.888,p < 0.0001) and "economy" in secondary AI (rho = 0.854,p < 0.0001). Working restrictions increased occupational concern. CORTI-COVID correlated inversely with QoL. AddiQoL-30 and SF-36 correlated strongly. Comorbidities worsened patients' QoL. Conclusion If educational efforts are made in preventing acute events, AI patients seem not particularly susceptible to COVID-19. The novel "CORTI-COVID" questionnaire reliably assesses the pandemic-related emotional burden in AI. Even under unconventional stress, educated AI patients preserve a good QoL.